W. Ng, H. Tong, W. Ng, J. H. Yeung, Joyce Kit Yu Young, R. K. Woo, M. Wong
tlooto Summary
The case of a 73-year-old man with invasive pulmonary aspergillosis treated with voriconazole and APAP for analgesia with a cumulative dose of 160 g over 40 days is reported, which showed significant hyper-excretion of pyroglutamic acid.
Abstract
Abstract Pyroglutamic acidosis (PGA) is an underrecognized entity characterised by raised anion gap metabolic acidosis (RAGMA) and urinary hyper-excretion of pyroglutamic acid. It is frequently associated with chronic acetaminophen (APAP) ingestion. We report the case of a 73-year-old man with invasive pulmonary aspergillosis treated with voriconazole and APAP for analgesia with a cumulative dose of 160 g over 40 days. PGA was suspected as he developed severe RAGMA and common causes were excluded. Diagnosis was confirmed via urinary organic acid analysis which showed significant hyper-excretion of pyroglutamic acid. APAP was discontinued, and N-acetylcysteine (NAC) was administered. His RAGMA rapidly resolved following treatment.
Citation format
NG, W., et al. Pyroglutamic acidosis – an underrecognised entity associated with acetaminophen use. Romanian Journal of Anaesthesia and Intensive Care, 2023, 30: 26–30.